The effect of rectus reapproximation on postoperative muscle strength and core endurance in cesarean section: A prospective case-control study


Demir Çaltekin M., Doğan H., Onat T., Aydoğan Kırmızı D., Başer E., Yalvaç E. S.

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, vol.48, no.3, pp.709-718, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 48 Issue: 3
  • Publication Date: 2022
  • Doi Number: 10.1111/jog.15153
  • Journal Name: JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.709-718
  • Keywords: cesarean section, core endurance, muscle strength, postoperative pain, rectus muscle reapproximation, POSTPARTUM WOMEN, RISK-FACTORS, ABDOMINIS, PREVALENCE, PREGNANCY, CONTRACTION, DELIVERY, DISTANCE, MASS
  • Yozgat Bozok University Affiliated: Yes

Abstract

Aim The necessity of the reapproximation technique of the rectus abdominis muscle in the cesarean section (CS) is a controversial issue. We aimed to investigate the effect of the approximation of the rectus abdominis muscle in CS on postoperative pain intensity, muscle strength, and core endurance. Methods Thirty-eight women whose rectus muscle was reapproximated in CS and 36 women whose muscles were not reapproximated were included in the study. All women were called in for evaluation in the postoperative period twice, in the 8th-10th and 24-26th weeks. While muscle strength was assessed by manual muscle test (MMT), core endurance was assessed by core stability tests [trunk flexion test (TFT), trunk extensor endurance test (TEET), lateral right/left bridge test (LRBT/LLBT)]. The distance between inter-rectus diastasis (IRD) and rectus abdominis muscle thickness were evaluated by ultrasonography. Results In the first evaluation; in the RMR group, lower and upper IRD values were less than the control group, while muscle strength, TFT, TEET, LRBT, and LLBT times were higher (p < 0.001, <0.001, 0.014, <0.001, <0.001, 0.002, and <0.001, respectively). In the second evaluation; in the RMR group, lower and upper IRD values were lower than the control group, while upper rectus abdominis muscle thickness, TFT, TEET, and LRBT times were higher (p < 0.001, <0.001, 0.046, <0.001, 0.032, and 0.010, respectively). Conclusion RMR in CS increases muscle strength and core endurance in the early postoperative period. RMR can facilitate the daily work of mother by increasing their physical fitness, especially in the early postoperative period.